Thirty Vendors Seek 2019 NCQA Measure Certification℠

Certified measures are exempt from source code review during an NCQA HEDIS® Compliance Audit™ and VBP4P Audit Review™

October 1, 2018

WASHINGTON, DC—The National Committee for Quality Assurance (NCQA) announced that 30 vendors will seek certification for software code that produces administrative measure results related to the Healthcare Effectiveness Data and Information Set (HEDIS®) and Integrated Healthcare Association’s (IHA) California Value Based Pay for Performance (VBP4P) measurement sets.

NCQA Measure Certification proves that vendors have the ability to produce accurate and reliable results using their software code. Health plans using NCQA-Certified vendors save time by eliminating the manual source-code review portion of the HEDIS Compliance Audit and the VBP4P Audit Review. This year’s program includes four new performance measures:

  • Risk of Continued Opioid Use (COU)
  • Hospitalization Following Discharge from a Skilled Nursing Facility (HFS)
  • Adult Immunization Status (AIS)*
  • Prenatal Immunization Status (PRS)*

*Measures that are collected using electronic clinical data systems.

Testing also includes the 2019 Quality Rating System measure set, which comprises clinical measures from HEDIS and a Pharmacy Quality Alliance measure, Proportion of Days Covered.

Thirteen of the 30 vendors are seeking VBP4P certification. Vendors that choose this type of certification are testing the VBP4P measurement set.

Inovalon and Interpreta, Inc. are this year’s beta-test sites.

Inovalon is a leading technology company providing cloud-based platforms empowering data-driven healthcare. Through the Inovalon One® Platform, Inovalon brings to the marketplace a national-scale capability to interconnect with the healthcare ecosystem, aggregate and analyze data in real-time, and empower the application of resulting insights to drive meaningful impact at the point of care.

Interpreta optimizes quality of care, risk adjustment, member prioritization, and precision medicine in real-time. By continuously interpreting clinical and genomic data, Interpreta creates a dynamic, shared, and personalized roadmap for physicians, patients, and key stakeholders. Interpreta integrates many applications to enable real-time population management.

For vendor contact information and certification status updates, or to request an application, click here. For more information on NCQA Measure Certification programs, contact Sara Vasquez, NCQA Measure Certification Assistant Director.

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